Provider Demographics
NPI:1689957722
Name:HRD CORP, INC
Entity Type:Organization
Organization Name:HRD CORP, INC
Other - Org Name:PRIME PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARBARINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-727-8191
Mailing Address - Street 1:201 HUMBOLDT AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02120
Mailing Address - Country:US
Mailing Address - Phone:617-427-2222
Mailing Address - Fax:617-427-2205
Practice Address - Street 1:201 HUMBOLDT AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02120
Practice Address - Country:US
Practice Address - Phone:617-427-2222
Practice Address - Fax:617-427-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADS897813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy